Kilkhampton Lodge

Updated 28 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by an inspector and a specialist advisor with experience of working with people with a learning disability, autism and/or conditions related to their mental health.

Service and service type

Kilkhampton Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We met with five people who used the service and six members of staff including the registered manager, deputy manager, a senior care worker and three care workers. Not everyone living at Kilkhampton Lodge was able to tell us about their experiences and we observed people with staff.

We reviewed a range of records. This included four people’s care records and one person’s medication records. We looked at one staff file in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures, meeting minutes and training records were reviewed.

After the inspection

We spoke with three professionals who regularly visit the service. We received feedback from three relatives about their experience of the service.

Updated 28 January 2020

Kilkhampton Lodge is a residential care home providing personal care for up to nine people with complex needs who have a learning disability, autism and/or mental health conditions. At the time of the inspection nine people were living at the service.

The service had been developed prior to publication of Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. Staff values were in line with the underlying principles of the guidance. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design. People had their own self-contained accommodation and most were able to choose whether to spend time in shared areas or on their own. The service was accessed via a long drive and was not visible from the road. There were no outward signs to indicate it was a care home.

People’s experience of using this service and what we found

People were protected from abuse by staff who had received relevant training and were confident about how to report any concerns. During the inspection we saw people approach staff to chat and request support. The number of incidents and use of restraint was low.

Staff were well supported by a system of induction, training and supervision. Most of the staff had worked at the service for over a year and knew people well. New staff worked alongside more experienced staff until they were confident to work alone.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Any changes in restrictive practices were highlighted to the relevant authority to help ensure they remained necessary and proportionate.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to gain new skills and become more independent.

Two people were living in segregated accommodation. This meant they lived entirely separately from others and were unable to access shared lounges and kitchens or leave their accommodation independently. This was done to keep them and others safe. These people were given choice and control in their basic daily routines, for example, deciding when to get up and go to bed. Staff had developed ways to help people to make choices using communication tools and simple sign language. They continued to work with other agencies to develop these techniques.

Care plans detailed people’s needs across a range of areas. Risk assessments guided staff on the actions they should take when people became distressed. There was also information about people’s preferences and background personal histories. This information helped staff to develop an understanding of people’s needs.

People living at Kilkhampton Lodge had very different and wide ranging needs. Care delivery was planned according to each individuals needs and preferences which were understood and respected by staff. Relatives told us they believed their family members received the support they needed. They were highly complimentary about staff and management.

The service was well managed. There were clear roles and responsibilities in place which were well understood by the whole staff team. Regular checks and audits were completed to help identify any areas for improvement. The management team kept up to date with changes in the sector through membership with online organisations and forums.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 27 July 2018)

Why we inspected

The inspection was brought forward following concerns raised regarding staff deployment and practices around hygiene.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.